Provider Demographics
NPI:1194343442
Name:MILETELLO, COURTNEY BRYAN (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:BRYAN
Last Name:MILETELLO
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:PAIGE
Other - Last Name:MILETELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:318-966-4470
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:309 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7407
Practice Address - Country:US
Practice Address - Phone:318-966-4470
Practice Address - Fax:318-966-4864
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA214383363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily